The impact of COVID-19 on stress and resilience in undergraduate nursing students: A scoping review

Fear of lacking access to mobile devices ("nomophobia"): A preliminary study of prevalence, predictors, and relationship to perceived stress in nursing students

BACKGROUND

Nomophobia, the fear of losing smartphone access, appears to be increasing among nursing students globally. Early findings suggest that it leads to stress and anxiety and impacts student learning and academic performance.

PURPOSE

To assess nomophobia and perceived stress levels and the predictive factors in nursing students.

METHODS

Cross-sectional surveys of 1030 nursing students at a university in Türkiye. The data were collected via paper questionnaires that included validated Turkish versions of the Nomophobia Questionnaire and the Perceived Stress Scale for Nursing Students.

DISCUSSION

Among the 808 students who responded, 48% had moderate and 24.5% had severe nomophobia. Sex, income, academic success, daily smartphone use duration, social media use, listening to music, and perceived stress were significant predictors of nomophobia. Year within the nursing program, income, watching videos, surfing the internet, and nomophobia were significant predictors of perceived stress.

CONCLUSION

Understanding nomophobia and its relationship to perceived stress is potentially critical to a healthy nurse workforce.

A mixed methods study of wellbeing and resilience of undergraduate nursing students: implications for the post-pandemic era

BACKGROUND

The COVID-19 pandemic and rapid shift to online learning have had ongoing impacts on nursing students' wellbeing and resilience. We are yet to fully understand the implications for this emerging workforce in the post-pandemic era. The aims of this mixed methods study were to investigate wellbeing, coping and resilience of undergraduate nursing students in the pandemic; explore relationships between these variables and investigate predictors of wellbeing and coping, including differences between domestic and international students; explore how students experienced and managed adversity; understand how their mental distress and wellbeing were influenced by resilience resources used to deal with adversity, and identify implications for nurse wellbeing as they enter the workforce in the post-pandemic era.

METHODS

A convergent mixed methods design was used. An online survey investigated wellbeing (COMPAS-W), psychological distress (DASS-21), coping (Brief COPE) and resilience (ARM-R) was completed by n = 175 undergraduate nursing students. Semi-structured interviews with n = 18 students explored how they navigated challenges. Descriptive, correlational, and regression analyses, and thematic analysis, were conducted. Mixed methods analysis was used to integrate both sets of findings.

RESULTS

Students reported high levels of mental distress, yet also moderate levels of wellbeing and resilience. Key findings included domestic students reporting significantly greater stress than international students, and wellbeing being predicted by lower mental distress and increased problem-focused coping. Students coped with challenges by being proactive, drawing on a range of coping strategies, and seeking technical and emotional support. From a social-ecological resilience perspective, access to and engagement with a range of personal, environmental and relational resources served as protective factors for their wellbeing.

CONCLUSIONS

This study provides valuable new insights into protective factors for nurses during a period of extraordinary challenge. In the post-pandemic era, there is a need to strengthen the wellbeing and retention of new graduates now entering the workforce from university. Implementation of targeted strategies to strengthen graduates' peer relationships and sense of belonging at work, and wellbeing and resilience education, are needed. Longitudinal follow-up of graduates' wellbeing is recommended.

Resilience of nursing students: A concept analysis study

OBJECTIVES

This study aimed to identify attributes of resilience among nursing students.

DESIGN

The concept analysis method was used.

DATA SOURCES

Literature reviews from the past 10 years were searched in Science Direct, Cumulative Index to Nursing and Allied Health Literature, PubMed, and the Wiley online library. The literature search database and review period were determined after verification of validity by five experts (nursing professors). The inclusion criteria for the literature review were that the paper must be written in English, and the abstract or title of the paper should have included attributes of nursing students' resilience. Exclusion criteria were papers written in languages other than English, papers that did not include the attributes of resilience of nursing students, and duplicate papers. Seventeen studies were included in the analysis.

RESULTS

Resilience among nursing students comprised three attributes and 28 sub-attributes. The three attributes were individual, educational, and situational. Individual attributes included personal competency characteristics (e.g., self-confidence and self-efficacy) and consisted of 15 sub-attributes. Educational attributes included characteristics related to academic and clinical practicum (e.g., coping with academic work pressure) and consisted of seven sub-attributes. Situational attributes comprised characteristics that changed according to circumstances (e.g., coping with increased levels of patient acuity during the crisis), such as the COVID-19 pandemic and social support from significant others, and consisted of six sub-attributes.

CONCLUSIONS

This study identified resilience attributes reflecting the characteristics of nursing students and recent situational changes. Consequently, tools to assess resilience should be developed based on study findings and utilized in various studies aimed at enhancing the resilience of nursing students.

Exploring the Levels of Stress, Anxiety, Depression, Resilience, Hope, and Spiritual Well-Being Among Greek Dentistry and Nursing Students in Response to Academic Responsibilities Two Years After the COVID-19 Pandemic

Background: Dentistry and nursing students experience significant anxiety, negatively impacting their well-being and academic performance. Objectives: This study aims to assess the prevalence and relationships of stress, anxiety, depression, resilience, hope, and spiritual well-being among dentistry and nursing students, identify demographic influences and propose strategies to enhance resilience and well-being. Methods: This study surveyed 271 students attending Greece's departments of dentistry and nursing at the National and Kapodistrian University of Athens, using an electronic questionnaire aimed to assess stress, anxiety, and depression (depression, anxiety, stress scale-DASS-21); resilience (resilience assessment questionnaire-RAQ8, brief resilience scale-BRS); hope (adult hope scale-AHS); and spiritual well-being (functional assessment of chronic illness therapy-spiritual well-being scale-FACIT-Sp-12). The survey also collected demographic data to identify factors influencing these variables. Statistical analyses, including hierarchical multiple linear regression and t-tests, were performed to analyze the relationships between variables. Results: The sample included 145 dentistry and 126 nursing students, with 68.6% female and 80.1% undergraduate. Half of the students reported mild or higher levels of stress (48.7%), anxiety (51.3%), and depression (53.5%). The prevalence of depression was the highest in our sample, followed by anxiety and stress. Higher family wealth was associated with reduced stress levels, while female undergraduate students reported higher levels of anxiety than their male counterparts. Hope was a strong predictor of resilience, but stress and worry had a negative correlation. Conclusions: Promoting students' well-being and academic success requires effective stress-reduction and resilience-building techniques to improve students' performance and support future healthcare professionals' personal sustainability and holistic growth.

Organizational resilience and its implications for healthcare workers in the COVID-19 pandemic: A literature review

Background

Organizational resilience is crucial in supporting the well-being of healthcare workers and ensuring the quality of healthcare services during crises like the COVID-19 pandemic. This study aims to comprehensively review organizational resilience of healthcare facilities in terms of its conception, measurement, and impacts on healthcare workers during the COVID-19 pandemic.

Methods

A search was conducted in four databases (PubMed, ScienceDirect, PsycINFO, and Web of Science) for empirical articles considering organizational resilience among healthcare facilities during the COVID-19 pandemic from 2019 to 2024. Several keywords from three categories ("COVID-19", "organizational resilience," and "healthcare facilities") were used, and RAYYAN was used to manage references.

Results

Four empirical articles from 172 studies were included, which encompassed a total sample of 6,606 healthcare workers from Switzerland, Saudi Arabia, Iran, and Türkiye. Organizational resilience could influence the individual resilience of healthcare practitioners, enhance crisis management and ensure safety performance. The strategies of enhancing organizational resilience at healthcare worker level included staff training, crisis management protocols, collaboration promotion, and stress management approaches. The ones at health facility level included government intervention, funds for hospital preparedness, competency-based crisis management, and mental health programs for healthcare workers. Our review also suggests a lack of empirical studies, no commonly used measurement instruments, and the heterogeneity of study contexts in the research of organizational resilience in public health.

Conclusions

This review highlights effective strategies to enhance the organizational resilience of healthcare workers and examines their impact during the COVID-19 pandemic. Immediate government action, funding to support hospital preparedness, and the formation of flexible healthcare teams are essential to strengthen organizational resilience among healthcare workers for future crises.

Exploring gender dynamics and predictors of resilience among nursing students

AIM

This study examined the gender differences in contributing factors to resilience among university nursing students, controlling for the age and year of study.

BACKGROUND

Resilience is a behavioral pattern learned through personal and professional experiences. Resilience is crucial in nursing education and shapes clinical proficiency and care quality that may best target during college years, preparing nursing students for their future careers.

DESIGN

Cross-sectional design was used in the current study METHODS: Online surveys were used to collect the data from 623 nursing students. Validated instruments assessed resilience, decision fatigue, spiritual well-being, stress overload and spiritual and religious coping. Two regression models were generated to examine gender dynamics in predicting resilience.

RESULTS

The results showed that more than half of our sample has low resilience (n = 285, 45.7 %). The regression model significantly predicted more than 60 % of the variance in resilience among male nursing students (F(3, 234) = 123.87, p <.001), with religious well-being, negative spiritual and religious coping and stress overload being significant predictors in the model. The regression model predicting resilience among female nursing students showed that the model significantly predicted about half of the variance (F(4, 378) = 123.87, p <.001) with positive spiritual and religious coping, existential well-being, negative spiritual and religious coping and stress overload being significant contributors in the model.

CONCLUSION

Gender disparities echoed existing literature, advocating gender-sensitive strategies in promoting resilience. Early resilience nurturing through diverse modalities can foster a resilient nursing cohort adept at tackling multifaceted healthcare challenges.

Assessing mental resilience with individual and lifestyle determinants among nursing students: An observational study from Greece

The educational environment is important for the development of life skills of nursing students in late- and post-adolescence. Strengthening their mental resilience, enhancing their individual confidence, and controlling stress are necessary conditions in this direction, which will help them cope with the future challenges of their chosen profession. We aimed to study the resilience profiles of nursing students by investigating their mental resilience and its association with their individual characteristics and lifestyle factors. The Connor-Davidson Resilience Scale (CD-RISC-25) scale for resilience, the Perceived Stress Scale (PSS-14) scale for perceived stress, and the Personal Trust and Connection (PerTC) scale for trust and connections were used. The lifestyle determinants were also assessed. An e-survey that targeted 250 nursing students was conducted from November 22 to April 23. Descriptive and advanced statistical analyses were performed. 146 students participated in the study via an on-line questionnaire; the students were predominantly female (82.2%) with mean age of 22 years (SD = 6.8). Two out of ten students smoked (20.5%), 66.4% consumed at least one drink during a usual week, and 48.0% participated in sports during the last year. The mean hours spent on the Internet daily was 4.2 (SD = 1.8) and on social media was 2.7 (SD = 1.6) hours/day. The students scored highly on the 1-to-10 life-satisfaction item (Mean = 6.3, SD = 1.9), where the perceived stress was assessed as moderate/high with a mean of 33 (SD = 4.4) and trust and connections had a mean of 6.2 (SD = 1.1). In the multivariate analysis, the factors found to significantly associate with resilience (CD-RISC-25; Mean = 64.2, SD = 11.8) were age (β = 0.4; 95% CI: 0.1, 0.7), sports participation (β = 5.7; 95% CI: 2.3, 9.1), hours per day spent on social media (β = -1.3; 95% CI: -2.3, -0.3), and the number of friends (β = 0.3; 95% CI: 0.05, 0.5). Finally, resilience was positively associated with life satisfaction and the trust and connections scale (β = 1.8; 95% CI: 0.9, 2.7 and β = 1.8; 95% CI: 0.2, 3.4, respectively).

Over twenty years of pedagogical research from Nurse Education in Practice: A bibliometric analysis from 2001 to 2023

AIM

To present a bibliometric overview of pedagogical research from Nurse Education in Practice from its inception in 2001 up until 2023.

BACKGROUND

Bibliometric methods are useful in analysing and understanding the characteristics of scientific publications in a particular field and the influence of specific journals. However, no bibliometric analysis of a nurse education journal has been undertaken to date which would highlight important research trends in this area of nursing and midwifery.

METHODS

A total of 2231 publications (articles and reviews only) from Nursing Education in Practice were retrieved from the Scopus database between 2001 and 2023. Several software applications including Microsoft Excel and VOSviewer were used to undertake bibliometric analysis on this dataset. Publication trends such as country analysis, author analysis, keywords analyses (cluster, content and trend analysis) were generated to help understand the volume and scope of pedagogical nursing and midwifery research in this journal.

RESULTS

There has been a steady increase in pedagogical research from Nurse Education in Practice since its launch in 2001 up until 2018, with a dip in publications in 2022 most likely due to the impact of restrictions during the coronavirus pandemic. The most prolific institutions publishing in the journal are mainly from the United Kingdom, Australia and the United States, with over eighty countries represented demonstrating its global reach and impact. Nursing students, nursing education, simulation and learning are some of the most frequent author keywords.

CONCLUSION

The diversity of pedagogies in nursing and midwifery education, clinical learning and supervision in practice environments, and competence and confidence when transitioning to practice are the most popular research areas in Nurse Education in Practice. This study informs nurse and midwife educators and scholars about the volume and scope of pedagogical research in nursing and midwifery. It also makes recommendations on how to improve aspects of scholarship in education and areas for future pedagogical research.